–455 G/A polymorphism and preprocedural plasma levels of fibrinogen show no association with the risk of clinical restenosis in patients with coronary stent placement

Pascalle S. Monraats; Jamal S. Rana; Aeilko H. Zwinderman; Moniek P. M. de Maat; John P. Kastelein; Willem R. P. Agema; Pieter A. F. Doevendans; Robbert J. de Winter; René A. Tio; Johannes Waltenberger; Rune R. Frants; Arnoud van der Laarse; Ernst E. van der Wall; J. Wouter Jukema

doi:10.1160/TH04-11-0708

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(03): 564-569
DOI: 10.1160/TH04-11-0708

Cell Signalling and Vessel Remodelling

Schattauer GmbH

–455 G/A polymorphism and preprocedural plasma levels of fibrinogen show no association with the risk of clinical restenosis in patients with coronary stent placement

Authors

Pascalle S. Monraats

¹Department of Cardiology, Leiden University Medical Center, The Netherlands

²Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
Jamal S. Rana

¹Department of Cardiology, Leiden University Medical Center, The Netherlands

³Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
Aeilko H. Zwinderman

⁴Department of Medical Statistics, Academic Medical Center, Amsterdam, The Netherlands
Moniek P. M. de Maat

⁵Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
John P. Kastelein

³Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
Willem R. P. Agema

¹Department of Cardiology, Leiden University Medical Center, The Netherlands

²Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
Pieter A. F. Doevendans

⁶Department of Cardiology, University Medical Center Utrecht, The Netherlands
Robbert J. de Winter

⁷Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
René A. Tio

⁸Department of Cardiology, Academic Hospital Groningen, The Netherlands
Johannes Waltenberger

⁹Department of Cardiology, Academic Hospital Maastricht, The Netherlands
Rune R. Frants

¹⁰Department of Human Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, The Netherlands
Arnoud van der Laarse

¹Department of Cardiology, Leiden University Medical Center, The Netherlands
Ernst E. van der Wall

¹Department of Cardiology, Leiden University Medical Center, The Netherlands
J. Wouter Jukema

¹Department of Cardiology, Leiden University Medical Center, The Netherlands

²Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands

Abstract

Summary

The effect of preprocedural fibrinogen levels on in-stent restenosis is largely unknown. The –455 G/A polymorphism of the fibrinogen β-gene is associated with baseline plasma level or acute phase increase of fibrinogen. Therefore, we hypothesized that there is a relationship between this polymorphism and pre-procedural fibrinogen level and clinical restenosis at follow-up among patients with coronary stent placement. The GENetic DEterminants of Restenosis (GENDER) project is a multicenter follow-up study that enrolled 3,146 consecutive patients after successful percutaneous coronary intervention. A coronary stent was placed in 2,309 patients. Of these, 2,257 (97.7%) patients were successfully genotyped for the –455G/A polymorphism. Plasma fibrinogen levels were measured at baseline in a subpopulation of 623 stented patients with the von Clauss method and patients were grouped into tertiles according to fibrinogen levels. Primary endpoint was target vessel revascularization (TVR); secondary combined endpoint was defined as death presumably from cardiac causes, MI not attributable to another coronary artery than the target vessel, and TVR. No association was observed between the –455G/A polymorphism and TVR or combined endpoint (p=0.99, p=0.97, respectively). Multivariate regression analysis revealed that the risk of TVR and combined endpoint was not higher for patients in the highest tertile for fibrinogen versus the lowest tertile (RR=0.60, 95% CI: 0.26–1.37 for TVR, RR=0.64, 95% CI: 0.29–1.44 for combined endpoint). In conclusion, the presence of –455G/A polymorphism in the fibrinogen β-gene and preprocedural fibrinogen level is not associated with an increased risk of TVR or combined endpoint in a patient population with coronary stent placement. Therefore, these parameters are not worthwhile for stratifying patients at risk for restenosis prestenting.

Keywords

Fibrinogen - coronary stent - restenosis - genetics

Full Text

References

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